Public Health, Welfare and Labor Committee- House
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Bills discussed (43)
| Bill | Title | Sponsor | Status |
|---|---|---|---|
|
HB1428
· 3 mentions in agenda, chapter, transcript
Matched: “…AL HAIR (CROWN) ACT. REGULAR AGENDA Number Sponsor Subtitle HB1428 Miller TO CREATE THE MEDICAID EXPANSION EFFICIENCY ACT OF 2…”
|
TO CREATE THE MEDICAID EXPANSION EFFICIENCY ACT OF 2021; AND TO DECLARE AN EMERGENCY. | Miller | Died in House Committee at Sine Die Adjournment |
|
HB1016
· 2 mentions in chapter, agenda
Matched: “HB1016 Rye ALEX'S LAW: TO IMPROVE RESIDENTIAL SWIMMING POOL SAFETY…”
|
ALEX'S LAW: TO IMPROVE RESIDENTIAL SWIMMING POOL SAFETY TO PREVENT CHILD DROWNINGS. | Rye | Died in House Committee at Sine Die Adjournment |
|
HB1233
· 2 mentions in chapter, agenda
Matched: “HB1233 Penzo TO CREATE THE ARKANSAS NATUROPATHIC PHYSICIAN LICENSU…”
|
TO CREATE THE ARKANSAS NATUROPATHIC PHYSICIAN LICENSURE ACT. | Penzo | Recommended for study in the Interim by Joint … |
|
HB1247
· 2 mentions in chapter, agenda
Matched: “HB1247 Gonzales TO MODIFY PHYSICIAN DISPENSING; AND TO ALLOW DELEG…”
|
TO MODIFY PHYSICIAN DISPENSING; AND TO ALLOW DELEGATION OF PHYSICIAN DISPENSING. | Gonzales | Died in House Committee at Sine Die Adjournment |
|
HB1263
· 2 mentions in agenda, chapter
Matched: “…HILDREN, PREGNANT WOMEN, AND POSTPARTUM MOTHERS AND BABIES. HB1263 Pilkington TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSIS…”
|
TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSISTANT ACT; AND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS. | Pilkington | Died in House Committee at Sine Die Adjournment |
|
HB1324
· 2 mentions in agenda, chapter
Matched: “…ESIDENTIAL SWIMMING POOL SAFETY TO PREVENT CHILD DROWNINGS. HB1324 Gazaway TO GIVE PREGNANT WOMEN PRIORITY ACCESS TO SUBSTANCE…”
|
TO GIVE PREGNANT WOMEN PRIORITY ACCESS TO SUBSTANCE ABUSE TREATMENT AND RECOVERY SERVICES; AND TO … | Gazaway | Died in House Committee at Sine Die Adjournment |
|
HB1498
· 2 mentions in agenda, chapter
Matched: “…EATMENT AND RECOVERY SERVICES; AND TO DECLARE AN EMERGENCY. HB1498 Gazaway CONCERNING THE CIVIL ENFORCEMENT OF CERTAIN CAUSES…”
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CONCERNING THE CIVIL ENFORCEMENT OF CERTAIN CAUSES OF ACTION AGAINST A LONG-TERM CARE FACILITY BY … | Gazaway | Died in House Committee at Sine Die Adjournment |
|
HB1564
· 2 mentions in agenda, chapter
Matched: “…APBACK PROGRAM UNDER THE DIVISION OF ARKANSAS STATE POLICE. HB1564 Hawks TO AMEND THE TEACHER MANAGER INSTRUCTOR CERTIFICATION…”
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TO AMEND THE TEACHER MANAGER INSTRUCTOR CERTIFICATION RELATING TO BARBERS. | Hawks | Recommended for study in the Interim by Joint … |
|
HB1580
· 2 mentions in agenda, chapter
Matched: “…INK PRODUCTS FROM LICENSURE, CERTIFICATION, AND INSPECTION. HB1580 Scott TO CREATE THE COMMISSION ON RACIAL INEQUITIES IN MATE…”
|
TO CREATE THE COMMISSION ON RACIAL INEQUITIES IN MATERNAL MORTALITY. | Scott | Died in House Committee at Sine Die Adjournment |
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HB1644
· 2 mentions in chapter, agenda
Matched: “HB1644 Bentley TO AMEND THE LAW CONCERNING EDUCATIONAL REQUIREMENT…”
|
TO AMEND THE LAW CONCERNING EDUCATIONAL REQUIREMENTS UNDER THE CHILDCARE FACILITY LICENSING ACT; AND TO … | Bentley | Died in House Committee at Sine Die Adjournment |
|
HB1667
· 2 mentions in agenda, chapter
Matched: “…T A LONG-TERM CARE FACILITY BY A RESIDENT OF THAT FACILITY. HB1667 Furman TO CREATE THE UNIVERSAL LICENSING RECOGNITION ACT. H…”
|
TO CREATE THE UNIVERSAL LICENSING RECOGNITION ACT. | Furman | Died in House Committee at Sine Die Adjournment |
|
HB1681
· 2 mentions in agenda, chapter
Matched: “…BERS FROM LICENSING RESTRICTIONS BASED ON CRIMINAL RECORDS. HB1681 Payton TO CREATE THE FOOD FREEDOM ACT; AND TO EXEMPT CERTAI…”
|
TO CREATE THE FOOD FREEDOM ACT; AND TO EXEMPT CERTAIN PRODUCERS OF HOMEMADE FOOD OR … | Payton | WITHDRAWN BY AUTHOR |
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HB1757
· 2 mentions in agenda, chapter
Matched: “…ICAID PROGRAM FOR ALL THIRD PARTIES WHO ARE PRIMARY PAYERS. HB1757 Penzo TO REQUIRE CERTAIN INFORMED CONSENT WHEN PRESCRIBING…”
|
TO REQUIRE CERTAIN INFORMED CONSENT WHEN PRESCRIBING OR ADMINISTERING ORAL CONTRACEPTIVES. | Penzo | Died in House Committee at Sine Die Adjournment |
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HB1759
· 2 mentions in agenda, chapter
Matched: “…SCRIBING OR ADMINISTERING ORAL CONTRACEPTIVES. Page 2 of 3 HB1759 L. Johnson TO PROVIDE ADDITIONAL MEDICAID COVERAGE FOR CHIL…”
|
TO PROVIDE ADDITIONAL MEDICAID COVERAGE FOR CHILDREN, PREGNANT WOMEN, AND POSTPARTUM MOTHERS AND BABIES. | L. Johnson | Died in House Committee at Sine Die Adjournment |
|
HB1762
· 2 mentions in chapter, agenda
Matched: “HB1762 K. Ferguson TO CREATE THE CANCER PREVENTION AND CANCER PATI…”
|
TO CREATE THE CANCER PREVENTION AND CANCER PATIENT NAVIGATION ACT; AND TO IMPROVE THE CARE … | K. Ferguson | Died in House Committee at Sine Die Adjournment |
|
HB1764
· 2 mentions in agenda, chapter
Matched: “…708 Eaves CONCERNING REACTIVE ATTACHMENT DISORDER TRAINING. HB1764 F. Allen TO EXEMPT BARBERS FROM LICENSING RESTRICTIONS BASE…”
|
TO EXEMPT BARBERS FROM LICENSING RESTRICTIONS BASED ON CRIMINAL RECORDS. | F. Allen | Died in House Committee at Sine Die Adjournment |
|
HB1799
· 2 mentions in chapter, agenda
Matched: “HB1799 M. Gray TO ALLOW AUTOMATIC CLAIM CROSSOVER IN THE ARKANSAS…”
|
TO ALLOW AUTOMATIC CLAIM CROSSOVER IN THE ARKANSAS MEDICAID PROGRAM FOR ALL THIRD PARTIES WHO … | M. Gray | Died in House Committee at Sine Die Adjournment |
|
HB1857
· 2 mentions in agenda, chapter
Matched: “…EALTH READINESS ACT. DEFERRED BILLS Number Sponsor Subtitle HB1857 Gonzales TO MODIFY THE DUTIES OF THE ARKANSAS STATE MEDICAL…”
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TO MODIFY THE DUTIES OF THE ARKANSAS STATE MEDICAL BOARD AND THE ARKANSAS STATE OCCUPATIONAL … | Gonzales | Recommended for study in the Interim by Joint … |
|
HB1871
· 2 mentions in chapter, agenda
Matched: “HB1871 Scott TO ESTABLISH THE CREATING A RESPECTFUL AND OPEN WORLD…”
|
TO ESTABLISH THE CREATING A RESPECTFUL AND OPEN WORLD FOR NATURAL HAIR (CROWN) ACT. | Scott | Died in House Committee at Sine Die Adjournment |
|
HB1911
· 2 mentions in chapter, agenda
Matched: “HB1911 Bryant TO AMEND THE LAW REGARDING PUBLIC ASSISTANCE; AND TO…”
|
TO AMEND THE LAW REGARDING PUBLIC ASSISTANCE; AND TO AUTHORIZE A PILOT PROGRAM RELATED TO … | Bryant | Recommended for study in the Interim by Joint … |
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HB1923
· 2 mentions in agenda, chapter
Matched: “…CE STATUS WHEN POTENTIAL RESIDENTS SIGN CONTRACTS FOR CARE. HB1923 S. Meeks TO MODERNIZE OUTDOOR LIGHTING; TO CREATE THE OUTDO…”
|
TO MODERNIZE OUTDOOR LIGHTING; TO CREATE THE OUTDOOR LIGHTING ACT; AND TO REPEAL THE SHIELDED … | S. Meeks | Died in House Committee at Sine Die Adjournment |
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SB259
· 2 mentions in agenda, chapter
Matched: “…ENTS IN THE STATE OF ARKANSAS; AND TO DECLARE AN EMERGENCY. SB259 Bledsoe TO AUTHORIZE THE LICENSURE OF STATE AND LOCAL GOVER…”
|
TO AUTHORIZE THE LICENSURE OF STATE AND LOCAL GOVERNMENT HEATING, VENTILATION, AIR CONDITIONING, AND REFRIGERATION … | Bledsoe | Died in House Committee at Sine Die Adjournment |
|
SB332
· 2 mentions in chapter, agenda
Matched: “SB332 Irvin TO ESTABLISH THE PUBLIC HEALTH READINESS ACT.”
|
TO ESTABLISH THE PUBLIC HEALTH READINESS ACT. | Irvin | Sine Die adjournment |
|
SB514
· 2 mentions in chapter, agenda
Matched: “SB514 B. Davis TO CREATE A LICENSE TO AUTHORIZE A COMPANY TO PROV…”
|
TO CREATE A LICENSE TO AUTHORIZE A COMPANY TO PROVIDE SKILLED NURSING TASKS. | B. Davis | Died in House Committee at Sine Die Adjournment |
|
SB590
Act 1002
· 2 mentions in agenda, chapter
Matched: “…SE TO AUTHORIZE A COMPANY TO PROVIDE SKILLED NURSING TASKS. SB590 T. Garner TO END MANDATORY FACE COVERING REQUIREMENTS IN TH…”
|
TO END MANDATORY FACE COVERING REQUIREMENTS IN THE STATE OF ARKANSAS; AND TO DECLARE AN … | T. Garner | Notification that SB590 is now Act 1002 |
|
SB625
Act 900
· 2 mentions in agenda, chapter
Matched: “…ECT REFERENCES TO THE APPROPRIATE CABINET-LEVEL DEPARTMENT. SB625 K. Hammer TO AMEND THE COSMETOLOGY TECHNICAL ADVISORY COMMI…”
|
TO AMEND THE COSMETOLOGY TECHNICAL ADVISORY COMMITTEE; AND TO ESTABLISH PROCEDURES FOR LICENSURE AND REGULATIONS … | K. Hammer | Notification that SB625 is now Act 900 |
|
HB1063
Act 829
· 1 mention in chapter
Matched: “HB1063 Dotson TO AMEND THE TELEMEDICINE ACT; TO AUTHORIZE ADDITION…”
|
TO AMEND THE TELEMEDICINE ACT; TO AUTHORIZE ADDITIONAL REIMBURSEMENT FOR TELEMEDICINE VIA TELEPHONE; AND TO … | Dotson | Notification that HB1063 is now Act 829 |
|
HB1177
Act 827
· 1 mention in chapter
Matched: “HB1177 L. Johnson TO AUTHORIZE EMERGENCY MEDICAL SERVICES PERSONNE…”
|
TO AUTHORIZE EMERGENCY MEDICAL SERVICES PERSONNEL TO ADMINISTER CERTAIN EMERGENCY PRESCRIPTION MEDICATIONS TO A PATIENT … | L. Johnson | Notification that HB1177 is now Act 827 |
|
HB1266
· 1 mention in chapter
Matched: “HB1266 M. Gray TO CLARIFY THE PROFESSIONAL RELATIONSHIP REGARDING…”
|
TO CLARIFY THE PROFESSIONAL RELATIONSHIP REGARDING COSMETIC AESTHETIC SERVICES. | M. Gray | Died in House Committee at Sine Die Adjournment |
|
HB1366
· 1 mention in agenda
Matched: “…ARE MIGRANTS FROM THE COMPACT OF FREE ASSOCIATION ISLANDS. HB1366 Penzo TO CREATE A RAPBACK PROGRAM UNDER THE DIVISION OF ARK…”
|
TO CREATE A RAPBACK PROGRAM UNDER THE DIVISION OF ARKANSAS STATE POLICE. | Penzo | Recommended for study in the Interim by Joint … |
|
HB1378
· 1 mention in chapter
Matched: “HB1378 Penzo TO AUTHORIZE OCCUPATIONAL OR PROFESSIONAL LICENSURE F…”
|
TO AUTHORIZE OCCUPATIONAL OR PROFESSIONAL LICENSURE FOR INDIVIDUALS WHO ARE MIGRANTS FROM THE COMPACT OF … | Penzo | Died in House Committee at Sine Die Adjournment |
|
HB1708
· 1 mention in chapter
Matched: “HB1708 Eaves CONCERNING REACTIVE ATTACHMENT DISORDER TRAINING.”
|
CONCERNING REACTIVE ATTACHMENT DISORDER TRAINING. | Eaves | Died in House Committee at Sine Die Adjournment |
|
HB1836
Act 812
· 1 mention in chapter
Matched: “HB1836 Vaught TO AMEND THE LAW REGARDING THE DIVISION OF ENVIRONME…”
|
TO AMEND THE LAW REGARDING THE DIVISION OF ENVIRONMENTAL QUALITY; AND TO AMEND THE PENALTY … | Vaught | Notification that HB1836 is now Act 812 |
|
HB1890
Act 1092
· 1 mention in chapter
Matched: “HB1890 Ladyman TO CREATE A STUDY ON THE COMMERCIAL APPLICATION OF…”
|
TO CREATE A STUDY ON THE COMMERCIAL APPLICATION OF EXISTING TECHNOLOGY TO RECLAIM AND REPURPOSE … | Ladyman | Notification that HB1890 is now Act 1092 |
|
HB1910
Act 1094
· 1 mention in chapter
Matched: “HB1910 Christiansen TO AMEND THE LAW CONCERNING THE AUTHORITY OF T…”
|
TO AMEND THE LAW CONCERNING THE AUTHORITY OF THE ARKANSAS FIRE PROTECTION SERVICES BOARD. | Christiansen | Notification that HB1910 is now Act 1094 |
|
HB1919
· 1 mention in agenda
Matched: “…E EMPLOYMENT AND INCOME DATA FOR CERTAIN PUBLIC ASSISTANCE. HB1919 Christiansen TO REQUIRE NURSING HOMES TO DISCLOSE LIABILITY…”
|
TO REQUIRE NURSING HOMES TO DISCLOSE LIABILITY INSURANCE STATUS WHEN POTENTIAL RESIDENTS SIGN CONTRACTS FOR … | Christiansen | Recommended for study in the Interim by Joint … |
|
HB1935
· 1 mention in chapter
Matched: “HB1935 Wing TO AMEND THE WORKERS' COMPENSATION LAW; AND TO PROVIDE…”
|
TO AMEND THE WORKERS' COMPENSATION LAW; AND TO PROVIDE FOR THE COMPENSABILITY OF MENTAL INJURY … | Wing | Died in House Committee at Sine Die Adjournment |
|
SB388
Act 949
· 1 mention in chapter
Matched: “SB388”
|
TO MODIFY LAWS CONCERNING ABORTION CLINICS. | Beckham | Notification that SB388 is now Act 949 |
|
SB395
Act 891
· 1 mention in chapter
Matched: “SB395 Irvin TO MODIFY THE ANNUAL CAP ON DIAGNOSTIC LABORATORY SER…”
|
TO MODIFY THE ANNUAL CAP ON DIAGNOSTIC LABORATORY SERVICES IN THE ARKANSAS MEDICAID PROGRAM. | Irvin | Notification that SB395 is now Act 891 |
|
SB547
Act 947
· 1 mention in chapter
Matched: “SB547 T. Garner TO AMEND CERTAIN PROVISIONS OF INITIATED ACT 4 OF…”
|
TO AMEND CERTAIN PROVISIONS OF INITIATED ACT 4 OF 1948; AND TO REGULATE A DIRECT … | T. Garner | Notification that SB547 is now Act 947 |
|
SB595
Act 1017
· 1 mention in chapter
Matched: “SB595 D. Wallace TO CLARIFY THAT THE DEPARTMENT OF HUMAN SERVICES…”
|
TO CLARIFY THAT THE DEPARTMENT OF HUMAN SERVICES IS THE AGENCY THAT REGULATES LONG-TERM CARE … | D. Wallace | Notification that SB595 is now Act 1017 |
|
SB621
Act 899
· 1 mention in chapter
Matched: “SB621 Hester TO REQUIRE THE ARKANSAS MEDICAID PROGRAM AND THE DEP…”
|
TO REQUIRE THE ARKANSAS MEDICAID PROGRAM AND THE DEPARTMENT OF HUMAN SERVICES TO HAVE ALL … | Hester | Notification that SB621 is now Act 899 |
|
SCR7
· 1 mention in chapter
Matched: “SCR7 Irvin TO ENCOURAGE THE PURSUIT OF NATIONAL CANCER INSTITUTE…”
|
TO ENCOURAGE THE PURSUIT OF NATIONAL CANCER INSTITUTE DESIGNATION BY THE WINTHROP P. ROCKEFELLER CANCER … | Irvin | Approved by the Governor |
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If anyone would like to speak for or against the bill, please sign up at the sign-up sheet out here on my right. We have no new bills on the consent agenda. So again, we're going to try to go straight down the agenda. We've got a number of bills we're going to pass over, so I don't know how long we'll be here, but starting out with the consent agenda item, we will pass over that. Representative Scott is not here.
So it gets us to HB 1428, Representative Miller. Are you ready to run your bill? You are recognized. Mr. Chair, if it's okay, I would like to...
Speaker 5
1:00
given the content of this bill, would like
Representative Josh Miller
Unverified
1:05
to sit on the left. That was a joke. I appreciate you two forgetting that.
You know, it was good. Representative Miller, it's all in
Speaker 4
1:16
your perspective. You're actually on my right. Well, I normally am, Mr. Chair. I think
Speaker 10
1:21
you're right. You're recognized. All right, thank you. Folks, I'm not
Representative Josh Miller
Unverified
1:25
going to belabor the point everybody we've talked about this.
a bunch. I believe there is a better way of serving our Medicaid population, not just our expansion population, but everyone. We obviously have a somewhat stout contingent of that that feels the same way in the House, seeing as how we've tried to pass appropriation how many times now and it hasn't. What I would like to do is move
everyone who is currently receiving their health insurance that's on the Medicaid expansion population from these insurance companies over to fee-for-service Medicaid. It does two things. Levels of playing field
and it saves the state money. I know there's arguments that will be made and have been made that say, no, it doesn't, and we get more revenue from the insurance companies. A lot of the revenue that we get from
the insurance companies comes from us taxing ourselves on what we've paid out.
Also, I want to see Medicaid reimbursement rates raised all the way. I think we can do better as a state. It's not fair for some of our most vulnerable to have a hard time finding a physician or finding a specialist because they won't take new Medicaid patients or won't take Medicaid patients, period. And, you know, it's just I don't think it's right for somebody who's able-bodied, perfectly healthy,
and using the same tax dollars to be able to waltz in just about anywhere and be seen when our most vulnerable cannot. I believe it'll be better. I believe we can do a better job. And I also think this will help get some folks' attention.
I'd be happy to take a question. Representative Boyd, you're
Representative Justin Boyd
Unverified
3:35
recognized. Thank you, Mr. Chair. Thank you, Representative Miller, for bringing this up.
And this is a very important discussion and debate, and I'm glad we're having it. Just curious what kind of conversations you've had with the executive branch on the feasibility. Are there going to be issues getting the state ready to be able to do that? Or is there a reason we're using private companies just because we can't get the people to do it and know how we don't have the expertise? Just curious your thoughts and experience on that. Okay.
Representative Josh Miller
Unverified
4:08
number one i've not been in the governor's office or had any conversations with him
this year about this bill i have spoken at length at least twice with dhs miss gillespie and her team and i think we had very good discussions um it was not so much a matter of you know them, I didn't hear from them in our discussions, and if I'm remembering incorrectly, I'm sorry, but I didn't hear from them that, oh, we can't do this because we're just not ready,
our infrastructure is going to cave or anything like that. I believe, you know, to your point about we've used the insurance companies, we've used the insurance companies since 2014 when this started because um it was supposed to be some genius conservative plan um that was you know because in 2013 this bill right now if i had run this bill in 2013 i don't believe it would have
Speaker 17
5:20
passed or maybe well if i ran it i would
Representative Josh Miller
Unverified
5:24
have been the the one republican i guess that would that that that would have voted for it and i would have also been primaried and wouldn't be here today because I would have got run out of my district. It's crazy how times have changed. But, you know, the bottom line is I feel like the insurance companies are the biggest benefactors. And I don't think that's right. I think hospitals, specialists, doctors,
healthcare providers, pharmacists, especially pharmacists, Representative Boyd, I think that all these folks should benefit on a level playing field with what we're doing as far as our tax dollars, if that makes sense. I hope that answers your
question. You got a follow-up? Yes, please. You're recognized. Thank
Representative Justin Boyd
Unverified
6:18
you, Mr. Chair. So I do want to have a follow-up here because you mentioned some other things.
So, one, there was what we just discussed, whether Medicaid could actually come in and have the employees and infrastructure within it to do it. The other thing is that you mentioned it's extremely important because we still have a lot of people on Medicaid, traditional Medicaid, and you mentioned the inadequate reimbursement in that program. And so, I mean, if you had discussions on what it would take to get the reimbursement to our hospitals and our physicians' offices, and I'm not asking about pharmacies.
I think that's just fine. That doesn't need to change. But the other ones I do think are inadequate. So any comments you could have on that,
Representative Josh Miller
Unverified
7:05
I'd appreciate. Well, sure. I've spoken with several providers. I've not had lengthy conversations with DHS about what I would like to see happen, but I'll be happy to tell you. I think, and we've learned it this last summer, I think we've all had the experience of seeing how that reimbursement rates can be raised.
We don't legislate reimbursement rates, and that's not something I want to do. But I do want to see them raised. And obviously, we're the legislature. We have the ability to put the pressure on them to do that. I mean, just last summer, heck, we raised reimbursement rates quite a bit in several different categories. I don't think it was enough. I was glad to see us do it. But I believe that we can do more and do better.
and, you know, and it may not be, it may be a situation where it's not quite as high as what some of the insurance companies reimburse, but if you're, if you're, if you've got a bigger pool and they're all getting up there, then, you know, I think it can be more enticing to, to want to see some of our providers, you know, get in line with that or, or join up. Now, Now, I don't know how that process initiates, so I'm not going to lie and say I do, but I do know it can because we've just done it, and I think it's very important that we do it.
I really think it's important either way because it's kind of shameful what we're doing right now as a state with some of these reimbursement rates. So, you know, there's that aspect. So, anyway, I hope I covered your question. Representative Dotson, you're recognized
Representative Jim Dotson
Unverified
9:07
for a question. Thank you, Mr. Chair. Representative Miller, just with regards to this bill at this point,
I was scrolling through here and it's referenced a lot of Arkansas works and things like that that I know you're deleting some references and things like that. But now that the Our Homes bill is an act, I'm not entirely sure if some of this language has already been changed. Have you looked at that at all and considered amending us to update that? Obviously,
Representative Josh Miller
Unverified
9:39
you know, anytime we're in a situation like this where you almost have competing bills,
we have one that was passed and I'm assuming already signed in and all that kind of stuff. Now, the effective date, I don't believe, and I could, I'm sure it was Representative Gray's bill, I'm sure she can correct me here in a minute, but I'm not sure when the effective date of a lot of that was going to be, if it wasn't going to be until, you know, January 1st of next year, when the current waiver expires. obviously you know if i were to get this bill out of here and there were some language amendments
that needed to take place due to you know what we currently have if it is in effect right now you know
i'd be delighted to do that amend it whatever obviously i don't but i don't know that
thank you representative bentley you're recognized for a question thank
Representative Mary Bentley
Unverified
10:40
you chairman and representative Miller appreciate again you being a champion for our Medicaid recipients and for a lot of our constituents that are not getting the care that they need so I we won't belabor the point you
and I are both on the same page on this but do you not agree that a number of our constituents will get better care or Medicaid will get better care if we can raise the rates and get everybody free for service because I know some of them are not getting being seen at all now
Representative Josh Miller
Unverified
11:09
by specialists or it can't even get a new PCP. Yes, ma'am.
Thank you for bringing that up. I mean, I believe that we have a lot of folks who get great care now. I mean, we have a ton of great medical providers in our state who give great care.
I just think we, and I understand it's a business, you know, doctors and hospitals, whatever, they have a bottom line. They have a business, and there's only a certain amount of these very low-paying, low-reimbursement rate Medicaid patients that they can accept. And so that's why it's always bothered me that the private option, Arkansas Works, whatever, has created a two-tier system. It's our most vulnerable that lose the most, and it's insurance companies who gain the most.
Now, I also would like to touch on,
it is my hope that by doing this, we could raise the reimbursement rates, which includes not just the $280,000 to $300,000, whatever is on Arkansas Works right now, But the other, heck, whatever it was, six or 700,000 people that are, you know, on other forms of Medicaid.
I believe, you know, when you start looking at that, you know, that's a sizable pool of people. And, again, I just, you know, I want Arkansas to win. If you have to be a recipient of Medicaid, it's not because you're doing the best you've ever done in your life, or maybe it is, or whatever. You all understand what I'm saying. Even the folks on the expansion population, they're in a rough patch, and that's why I finally give up fighting Medicaid expansion.
I just want to do it affordably and do it what's fair. and so you know that's that's my view on that let's do it
let's do it affordably do it fairly yeah any other questions from committee
Representative John Payton
Unverified
13:35
representative payton you're recognized thank you mr chair so representative miller when you talk about raising the reimbursement rates how much do the insurance companies currently have as far as margin goes that could be shifted
towards raising those reimbursement rates? Thank you,
Representative Josh Miller
Unverified
13:59
Representative Payton. That's always a hot topic of discussion. The current law and what was just voted on requires that these insurance companies spend 80 percent of their revenue from the state on medical loss, taking care of sick people, whatever, paying doctor bills, hospital bills. And then that leaves 20 percent. Now some
claim that they, there's one company that claims that they spend over the 80 percent. So maybe they do, maybe they don't, but they're not required to. So they can adjust their things, whatever. I mean, pretty much the state guarantees them, if they want to and can make it work, guarantees these two companies a 20% profit margin. I don't know about any of y'all that are in business, but if I can invest in something with a guaranteed reimbursement rate,
if I'm going to make 20% of whatever amount I'm spending, I'm going to do two things. I'm going to invest a lot and I'm going to spend a lot to make my 20%. We're talking about a $2 billion program, a little bit over that. And, you know, the potential for these insurance companies to profit over $400 million of taxpayer funds is certainly there. I mean, we just had a big, long discussion in the House chamber today
over a $50 million appropriation for something. And, you know, I mean, that's state funds. I don't know why we'd waste our time having a discussion about that when we've been perfectly happy to spend, you know, $40 million or whatever in profit for these companies. Does that have a follow-up? Yes, you're
Representative John Payton
Unverified
15:57
recognized. Thank you, Mr. Chair. So I think it was mentioned a minute ago about how much workload this may place on DHS in management of shifting it over.
So how much workload is DHS currently doing to determine eligibility, get people enrolled, track them after they're enrolled, and how much of that would convert over? or do you really think it'd be an increase in workload or do you think it would end up being a wash or something minimal or what? I'm not
Representative Josh Miller
Unverified
16:32
going to say that there's not obviously a great possibility for an increase in workload.
I do believe that DHS is already kind of set up to do this. They're already taking care of, you know, whatever. They get the phone calls. They refer the folks. I mean, you walk in our local DHS office in Heber Springs and somebody goes in there and signs up. We have the personnel that are already there. Plus, I know that, and I'm happy to brag on DHS, I'm not against DHS. I have utmost confidence in Director Gillespie and her team that if this were to pass,
that they could set it up and it would run smoothly and efficiently. And I don't believe I don't believe we would experience a lot
of problem with that. Thank you. Representative
Representative Justin Boyd
Unverified
17:31
Boyd, you're recognized for a question. Thank you, Mr. Chair. So you mentioned Representative Miller, you mentioned medical loss ratio. And that's an important concept when you're you're looking at the plans and how they're they're paid. Medicaid. So there's been, you brought up the pharmacy program in previous comments. I think
they were kind of, you were looking at me when you said them, and so I wanted to talk a little bit about the pharmacy program, because what you're doing would affect pharmacy as well. And so currently they use a NADAC plus model to reimburse prescriptions. So the pharmacists, you know, pay for the prescriptions, and they can figure out what that publicized number NADAC is, and then they know that there's a fee and the point of Medicaid is to reimburse costs not to make money is my understanding of how government health care is supposed to work is it's a reimbursement
model not a money-making model so when you look at that model and you compare that to the qualified health plans who use PBMs and you had some of these cases like in Ohio where they found you know hey the they were sending money back to the plans I mean do you think maybe that's affecting the medical loss ratio possibly i mean is that something did you have discussions with dhs about that by
Representative Josh Miller
Unverified
18:44
any chance i did not have discussions with dhs about that in the
last several times i've had discussions uh concerning this bill i think we've all been aware of of the
issues that pharmacies were having uh with the expansion population a year or two ago and i've I've reached out to DHS whenever that was. It might have been two or three years ago. I just know that I think there's always, let's figure out
how to word this. When dealing with fee for service, our department would set the rates.
People would know what they're doing. And you know what you're going to get based on whatever. And like you said, it's not a money-making deal. It's not whatever. But when you start dealing with insurance companies, and one of the biggest problems I've always had with the insurance company model is
accountability. When DHS cuts the check, monthly or quarterly or whatever it is, to cover somebody's insurance plan, or their premium, I'm sorry,
we really have no control over that after that point, I mean, at all.
And I think we all got calls from pharmacists, and we've gotten calls from others. I know some of that's gotten better, and I hope it has. But I think it would be a whole lot easier and a whole lot more responsible with tax dollars to do this when we have it set. Reimbursement rates by Medicaid, just like we've always done, and we can raise those up.
Everybody agrees there's a problem with that. But anyway, I hope that kind of answers your question. I do think, I mean, obviously anything they do, the more they spend, I don't know that there's been that maybe one year since this program has been created, and y'all might can correct me, when these insurance companies who were participating hadn't come back to ask for a rate increase. You know, and then so if they get a 5% rate increase,
well then that 20% profit margin stands to also be a bigger number. Any other questions from committee? Seeing none, we have no
one signed up to speak for or against the bill. Does anyone in the audience to speak against the bill? Would you come to the table, introduce yourself and who you represent. Thank you, Mr. Chairman.
Speaker 56
21:45
Mark White with the Department of Human Services. If you could, I just want to just address
Speaker 57
21:50
a few points on the bill and that were discussed in the discussion just to make sure you all have good understanding of the choice that's before you.
First, I just want to talk about this issue of the rates. As we've said, it has been acknowledged in the discussion, one of the key differences in using the qualified health plans as opposed to using a fee-for-service model is that providers in that qualified health plan model, they are receiving commercial rates for seeing Medicaid beneficiaries. If this bill were to pass, if we were to transition to a fully fee-for-service system, then all those payments all those providers would drop down back to the medicaid rates and i haven't
heard any legislator who said that the medicaid rates are fine where they are i think there's a consensus there that they are low they need to be increased and and we recognize there are some areas where that does need to be done but if we go to fee for service it's going to drop all those rates down to that lower amount and of course you may say well let's just let's use that savings to raise the rates. Here's the problem. It's only a small, only a minority of our program is in expansion. And it's at that 10% match where we as a state had to put up 10% of the cost.
Most of our program is at a 30% match. And we can't raise rates on just one population. If we're going to raise those provider rates, that increase is going to cover that entire population, which means we're going to be paying 10 percent of that for this expansion population we're going to be paying 30 percent for most of the rest of that population and bottom line that means if we wanted to increase medicaid payment rates so that they're anywhere close to what providers are receiving in the qhp model it's going to take hundreds of millions of dollars in additional
and state general revenue, money that has not been allocated to DHS, that is not there unless, you know, we at some point try and find that, working with you all, looking at the budget. You know, it's not something we've got in our budget. So that's the problem. The inevitable result from going to a fee-for-service system is that provider rates are going to drop, providers are going to see less money, there's going to be less money going into our healthcare economy. Now, we modeled this out.
And based on the model we did, it would be about a $3 billion hit to Arkansas's health care economy. You can't take $3 billion out of the health care economy without seeing hospitals close, without seeing jobs lost. There is not that much fluff in our health care system that we can just pull out $3 billion. So that's our concern. And that's why when Secretary Gillespie started looking at this over a year ago now and started making plans for the next iteration of this program, we looked at could we go to a fee-for-service model?
Could we do something else? And that's what we kept running up against, that if we make a change, if we go to a different model, fee-for-service or whatever, it just has too much of a shock on our health care system. And that's why, in the end, we brought forward the Our Home proposal that is based on those qualified health plans. So that's the key issue there on the rates. Two other quick points. One, we hear this 80% figure about insurance companies and profits. That's medical loss ratio. That means that the insurance companies have to pay at least 80% of those premiums on medical claims.
That doesn't mean that 20% is profit. It means that out of what's left, they've got to pay all their administrative expenses. They've got to pay for their call centers. they've got to pay for their working providers, they've got to pay for their fraud prevention efforts. All of that has to be paid out of that additional 20%. So don't think that's 20% profit. That is not only profit, but also all those administrative costs that the carriers have. And then last point I want to touch on, you know, Representative Miller has talked very eloquently, very passionately about the needs of our beneficiaries who are not in the expansion population.
And we get that, and we agree. And that's why we've done a number of things this session and have several things going to try and improve what we have for those other beneficiaries in the rest of the program. And so that's why we're increasing the number of PCP visits available to beneficiaries in fee-for-service. That's why we've been supportive of the bill that's passed out. I think it was just this morning you all passed out a bill to increase the number of prescriptions available for beneficiaries on the traditional side of the program. And we're looking at expanding access and doing what we can to improve access to services for all those other folks
who are, again, some of our most neediest citizens on that side of the population. So hopefully that covers all the points. I'd be happy to answer any questions if the committee has any. And I appreciate Congressman Miller. I know we've had lots of discussions with he and Secretary Gillespie, good discussions. I know we didn't end up in the same place, but we just really appreciate the cooperative spirit that he brought to those discussions. Representative Boyd, you're recognized for a
Representative Justin Boyd
Unverified
26:58
question. Thank you, Mr. Chair. Later, I'm going to try to be quick, but I think that Representative Miller, you know, brought a bill,
and it's an important bill, and it needs to be vetted appropriately. So, first, I want to commend, you know, DHS on the changes to the traditional Medicaid program. It was way more than pharmacy. I mean, there were a lot of, we had a bill in here this morning that made changes, so thank you for that. But I guess it begs the question, though, if we don't, I mean, Representative Miller brought a bill because there's a different standard, and I think that's valid, and I think we have to understand as a legislative body why we're doing that. So I guess the alternative question is, why are we not placing everybody on qualified health plans?
If it doesn't make sense to bring everybody to a traditional Medicaid program, why do we need a
Speaker 58
27:48
separate standard? Thank you. I think there may be a number of reasons, but the key one really is, when
Speaker 57
27:54
we look at the rest of our Medicaid population, you're largely looking at two groups of folks. One is children, and children, fortunately for us, are not that expensive to cover, because most kids are relatively healthy. And so there's just not really any financial or other advantage to shifting that population to a QHP model, just because it's just not that expensive.
The other side of it is, that's our disabled and elderly population. And that's a population that has a lot of special needs, things that aren't you typically covered in QHPs. Just as an example, you know, for any beneficiaries on the fee-for-service side and in the state plan, you know, they're eligible for up to 64 hours a month of in-home personal care to help them with their activities of daily living. That's not something you would necessarily get if you were in a qualified health plan. And so for those beneficiaries, because they have those more unique needs and greater needs,
that we think that's real, that's something that's more in our wheelhouse and is better served
Speaker 60
28:53
on the fee-for-service side. Any other questions from committee? Representative
Speaker 47
28:59
Payton, you're recognized. Thank you, Mr. Chair.
Representative John Payton
Unverified
29:04
So there's a few issues that I try to figure out why we do it. But we're buying insurance for this population in the expansion. but if there's a medically frail person we sign them up on traditional medicaid they're the ones
that use more services so we're okay with the lower reimbursement rate with the one that's going to use more services but it it all comes back to the fact that until somebody's sick it doesn't cost anything in fee for service and for those that are in the expanded population we pay a monthly charge whether they're sick or not so i remember reading in the news reports
i don't remember hearing much about it down here but there was several thousand people signed up on the expansion that didn't exist, and they cost us money every month. Number one, I'd like to ask, did we ever get that money back from the insurance companies? Then number two, if that mistake is made on the fee for service, and you have people on the rolls that don't exist, they don't cost you anything. So can you answer on whether we ever got the money back, and do we still have
people that don't exist on the rolls and you know speak to that some
Speaker 58
30:29
thank you sure if i can start with the last
Speaker 57
30:32
one first i would say no we don't have that issue at this point i think we've got much better fraud detection and efforts to make sure that our rolls are clean where we have now what i think you're referring to if my memory is correct and i'll preface by saying i'm going by memory so i may have to go back and double check some of that it's it is it's not they didn't exist. They existed when they got on the program, but I think what happened is they came in,
maybe they went to the hospital because they were in the ER. The hospital got them enrolled in Arkansas Works or private option at the time, and then they left the state, or they couldn't be found. And that, I think, was the issues. They had folks that they had signed up, and we had enough at the beginning when they signed up, but then they couldn't be found later. We saw at least some of those folks drop off with the institution of the work requirement, but we also, again, going back to those better prevention tech, fraud prevention techniques we have now to verify that
people are there, I think we have a much better handle on that. And I, my memory is that there were a number where there were some sums recovered back from the carriers, but that has been several years. I'd have to go
back to double check that. Thank you. Representative Cloud, you're
Speaker 65
31:48
recognized for a question. Thank you, Mr. Chair. Mr.
Representative Joe Cloud
Unverified
31:51
White, we talked a lot about money and physicians get paid more with qualified health plans and hospitals do, and I'm all for that.
In your opinion, in the position that you've had for several years, do those participants of fee-for-service, do they get the same quality of health care that qualified health plan participants do? I would say, for the most part, yes. And
Speaker 57
32:15
we certainly do our best to go back and make sure that they do. But again, part of that is that they've got those more specialized needs, and we want to make sure they get all the care they need on that side. I think would it be better if their providers are being paid commercial rates?
Absolutely. But I think it comes back to the fiscal realities for the state of how much is the state willing to invest in that program in order to expand those commercial rates beyond just the expansion population. Any other questions?
Seeing none, thank you for your comments. Thank you. Anyone here to speak for the bill? Seeing none, anyone else here to speak against the bill?
Representative Josh Miller
Unverified
33:08
your bill? Yes, sir, I'll close real quick. First of all, I want to be very clear. This
is not a bill where I appreciate Mr. White's comments, and we've had some great dialogue, and I look forward to more in the future. There's a wide variety of things that we're working on, and I have the utmost respect for he and Director Gillespie and the rest of them over there. I think they're doing a good job.
They didn't create this, and so I don't blame them. What we have, and again, I'm just going to hit on it again, complete inequality as far as how we care for folks on government-funded health
care in our state. There's no way around it. There's no way around it. We just spent a while over there
in the chamber today discussing and passed a bill that is all about equality. The last several sessions. I mean, don't dare be
against equality. However, we've let this go on. And the fact is, if you have one of these qualified health plans, you walk in about
anywhere, and you're going to get seen, you don't have to
go very far. And I don't blame the doctors for that. If you are recently disabled, find yourself in a situation like I was in, where Medicaid was my only health care provider for two years before I even qualified to try to get Medicare. I wouldn't want that to happen to me now, because so
many places are not taking new Medicaid patients and y'all that sucks it
sucks to be the guy who gets the phone calls from some of y'all's districts from and
not just they're calling me because they know I've been in the situation and they're looking for help which is fine I'm
happy to help but that's a tough deal and they're and they ask why well I know somebody else that's on Medicaid and he
lives over here and he just jumped in his truck the other day when he got sick and
ran down the road to the guy that used to be my doctor but won't be anymore because I don't have my previous insurance and I'm on Medicaid. So now I've got to go to wherever, Timbuktu or whatever to get seen. That's a bad deal. And I do believe, I mean, touching on another one of what was said Mr. White mentioned a minute ago about it's not really a 20% possibility for a 20% profit margin with the insurance companies. Well, I tell you what, he wasn't wrong. There is some administrative
costs and different things, but for $400 million, I will be happy to start up a company today and take care of their administrative costs. I will be delighted. So I don't know if anybody with two insurance companies are in here, but see me later if you're interested. $400 million is a lot of money, and that's our tax dollars. Granted, maybe 10% of it is just from the state, but you know what? I know who pays federal taxes too, and all of us
do, and a lot of the people we
represent do i want to say all but um you know i was making a list here representative gray has me at a great disadvantage because when she's down here presenting a bill she's writing down notes and i'm just not that good a writer so i don't but my memory sucks so i was trying to jot some stuff down in my phone again another point I want to make a lot of times when you want
to look at who's making the money you want to follow the
money insurance companies are a lot of times doing better than our
hospitals are now I'm all about health care
I don't give a rip about health coverage I'm worried a lot more about the care
of our Kansas and you know you don't have to be a genius to look at this
and see the amount of money paid out and I know the hospitals all support this but you know I believe that I just want them to know I'm not against hospitals i want our hospitals to do well i
want all our our doctors our medical providers to do well and lastly i'm gonna shut up we're the only state the only state that is doing this
now it i would love to be on the train of believing that that
is because we are are the most superior state and have figured things out better than 49 others. And if we are and I'm wrong, I'll be happy to admit it. The two other states that started it dropped it. And I understand that we have some unique features about our state,
but we're not that unique population-wise to other states. There are other states that are similar to us, and they're not doing it this way. And I'm not saying that's a reason in and of itself. It's just something to think about. Why are we, since the 10 years Medicaid expansion has been a thing, why are we
the only one? So anyway, I'm closed. I'm done. Thank you.
Speaker 78
39:33
I'll make a motion due pass. I have a motion of due pass. any discussion on the
motion seeing none all in favor signify by saying aye aye all opposed nay no
Speaker 83
40:02
i'm gonna say the eyes have it call the roll Representative Cloud
Representative Davis Representative Davis Representative Perry Representative Penzo Representative Penzo Representative Wing Representative Wing Representative Pilkington
Representative Pilkington Representative Coleman Representative Coleman Representative Allen
Speaker 90
41:06
Representative Boyd No Representative Gonzales Representative Gray
Unknown speaker
41:15
Representative Billing Yes. Representative Payton. Yes. Representative Miller. Hell yes. Representative Dotson. Representative Dotson. Yes. Judge Byron. No. Yes. Oh, yes.
Speaker 83
41:47
Representative McGee. No. Representative Eubanks, Representative Eubanks, Representative Wardlaw, Representative Wardlaw. Chair Lady.
Representative, your bill has failed. Thank you. All right, committee. Okay. Going on down the agenda here, we're going to pass over HB 1911. Representative Christensen, are you in the room? Don't see him. So we'll pass over HB 1919. HB 1923, Representative Meeks, I don't think he's here today.
and uh committee hb 1935 was filed yesterday so we can't take up a bill for two days so that'll be heard on tuesday sb 514 the sponsor has called me and said that the senator will be here tuesday to present that bill so we're sb 590 representative wardlaw where'd he go he was just here a minute ago. There is. SB 590. You're recognized to present the bill.
Representative Jeff Wardlaw
Unverified
43:46
It has an amendment. I don't
think we adopted the amendment this morning. If we did, then I'd like to... No, we did not.
Okay. Thank you. Okay. The amendment's coming around. i will explain them yeah go ahead we looked at this morning so go ahead thank you mr chair the amendment does what you guys asked me to do this morning added in dys to make sure that all facilities that have mass dormitories or admissions can
still wear a mask we're definitely not making everybody happy we think we got the nursing on portion covered with the private business and with the ability for them to be able to still do it so they can comply with the CDC guidelines if if said guidelines are there so with that I'd make a motion to adopt the amendment. I have a
motion to adopt the amendment any discussion on the motion seeing none all in favor signify by saying aye all opposed nay motion carries your
Your amendment's been adopted. You're recognized to present the bill
Representative Jeff Wardlaw
Unverified
45:04
as amended. The bill pretty much is the amendment, Mr. Chair. I'd be happy to take any questions. We've pretty well already waded this
water this morning. Any questions from committee? Seeing none, anyone here to speak against the bill? Please introduce yourself and who you represent.
Speaker 115
45:30
Thank you Mr. Chair, members of the committee. I'm Laura Hsu. I'm general counsel
Chair
Unverified
45:39
for the Department of Health. We appreciate the opportunity to review the amendment that became the bill this morning and this afternoon. We do still have some concerns about the bill as it is written. We think that there are some unintended consequences with this bill. As you all know with the approval of ALC the public health emergency has been extended by 60 days and that's to allow for continued legislative efforts to enact executive orders and to provide
a rapid response if needed. And the governor also administered his executive order 21-7 on March 31st. The face covering directive was ended at the end of March based on the metrics and the science that have been evaluated over a period of time. This bill takes away the flexibility to react quickly. It also conflicts with the new legislative review process under Act 403 of 2021 because it provides no sunset provision if mitigation efforts were necessary in the future.
The amendment may exempt private businesses like hospitals, groceries, and restaurants that have already announced that they are continuing best practices and will require a mask, but it still states that all mandatory face coverings shall end by including without limitation the ones issued by the executive orders and the ADH directives. There are cities, counties, schools, higher ed educations that want mask requirements. Most were planning to reevaluate every 30 days or over the summer. This is taking away their local control. There are also health science schools with
clinical classes that have contact with immunocompromised patients. And while the amendment exempts the ADC, it does not exempt city jails or county detention facilities that may require masks for congregate settings to protect against litigation. We have a concern about the Department of Health's main office and the 92 local health units, which may not fall in the definition of healthcare facility. In section two, there's very broad language. It does this affect face masks or face shields for sports. It doesn't refer to COVID or the public health emergencies
as talking about sports face shields or protection for job related safety reasons. This also refers to only legislation, which infers that it's only during a session, which also conflicts with Act 403 of 2021, which is the new process for directives and public health emergencies during the interim. It prohibits the use of masks for all time. Are we talking about times with other diseases? What if we need to temporarily use a mask mandate during an outbreak? What if a local area needed it? There have been mumps outbreaks in northwest Arkansas.
We've had hep A outbreaks in northeast Arkansas. the bill sends the wrong message and while Arkansas has fully vaccinated about 25 percent of the people 16 and up and about 50 percent of individuals 65 and older we want to be able to continue to protect each other and respect each other and take it seriously while we get everybody else vaccinated and I believe we have Secretary Key here from the Department of
Speaker 117
48:36
Education to answer any specific questions about schools. Thank you. Any questions from committee? Representative
Representative Justin Boyd
Unverified
48:45
Boyd, you're recognized. Thank you, Mr. Chair. Ms. Hsu, I mean, I didn't see this amendment earlier. Maybe other committee members did, and something you said in your testimony made me look at this. So on the first page, do you have a copy of the amendment? Have you seen it? Yes, I have it in On C, at the very first place, it says the use of a face mask, face shield, or other face covering shall not be a condition for entry, education, or services. So, you said something about sports and other things, and to me, that excludes it, but you're an attorney.
I'm just curious why you don't think that that would exclude these other things where it might be necessary. Thank you. We're
Chair
Unverified
49:31
concerned about the fact that it's so broad. while it talks about state agencies in subsection b it does say entry education
Speaker 122
49:36
or services under subsection c and so it shall not be a condition so if if educators and school districts and local control wanted to
Chair
Unverified
49:44
use a mask mandate they would not be able to under this bill representative dottson you're recognized for a question thank you mr chair
Representative Jim Dotson
Unverified
50:04
this this morning, and I think this amendment is identical to the one we saw this morning, with the exception that it adds that DYS services exemption in there. Were you able to get with the sponsor of the amendment to address those concerns between this morning and this afternoon? I know we haven't
Speaker 122
50:29
We talked with Representative Wardlaw in the interim, and I've also reached out to Municipal League and Association of Counties to try and get their insight on this also. But we do think this is very broad. It does include a political subdivision of the state. It's my understanding that several cities and several counties and school districts have issued their own mask requirements. Follow-up? Yes,
Representative Jim Dotson
Unverified
50:52
you can have a follow-up. So, I guess, did you support the bill before it was amended?
Speaker 122
51:00
We were going to testify against the bill before it
Representative Justin Boyd
Unverified
51:08
was amended. Okay, thank you. Representative Boyd, you recognize. Thank you, Mr. Chair. And just a quick question. So, you believe this would, once it was approved and signed by
Speaker 18
51:15
the governor or let go into law or whatever, that it would end the mandate in Little Rock, Fayetteville, and Rogers
Speaker 115
51:23
immediately? That's my reading of it. Obviously, I don't represent the cities or the counties, but that's my reading of it.
Any other questions from committee? Seeing none, thank you for your comments. We have Christine Cryer signed up to speak against the bill. Please introduce yourself and
Speaker 135
51:51
who you represent. Thank you, Mr. Chairman. My name is Christine Cryer. I am the Chief Legal Counselor for the Department of Corrections. When I signed up to speak against the bill this morning, that was prior to the amendment being made. Now that the Department of Corrections has been added to the bill,
we no longer oppose it. Thank you. Thank you for your comments. Thank you. Okay, no one else has signed up to speak for or against the bill? Everyone in the audience who wants to speak against the bill? For the bill? Against? Against? I don't
Speaker 55
52:28
read. I'm not sign language. Please introduce yourself and who you represent. Sorry, Mr. Chairman. Mark White, Department of Human
Speaker 57
52:34
Services. This is probably more on the bill, but just a couple things I just want to make sure the committee is aware of just so everybody's on
the same page and we fully understand the effect of the bill. One, of course, we do appreciate the addition of DYS to the exemptions. That certainly does help us. Secondly, I just want to make sure everyone understands that we do have some federal mandates in some of our programs that we have to enforce CDC guidelines in certain types of facilities. Nursing homes are the most common example of that. But as Reverend Ward-Law said, he thinks that that private business exception allows us to continue to do that. And we don't disagree, but I just want to make sure that folks understand that this does not change those federal mandates that we have to enforce on
these other types of facilities. And then the other concern that I've heard from our folks that I'll just pass along to you and do with you as as you will. We so far as I know I don't know we've gotten a single complaint from any employees about having to wear a mask. I think we have heard complaints and worries from employees about working in an environment without mask and so I think there is a concern of is this going to create a recruitment issue for us if employees are not wanting to work in an environment where masks are not being used in this present climate. I can't
tell you that's going to happen. I have absolutely no proof whatsoever, but that's just a consideration that was brought to me, and I just wanted to share that with the committee, and that's all I have
here, Mr. Chairman. Any questions? Seeing none, thank you
for your comments. Okay, Representative, are you ready to close for your bill? Mr. Chair, I'd be closed. I'd make a motion, do pass as amended. I have a motion of do pass as amended. Any discussion on the motion. Seeing none, all in favor, signify by saying aye. Aye. All opposed, nay. No.
Ayes have it. Congratulations. Your motion has passed. Roll call. Start
Speaker 83
54:44
at the bottom. Okay. Representative Cloud. Yes. Representative Davis, Representative Davis, Representative Perry.
No. Representative Penzo, Representative Penzo. Representative Wing. Yes. Representative Pilkington, Representative Pilkington Representative Coleman Representative Allen Representative Allen
Representative Boyd Representative Gonzalez Representative Gray Yes Representative Bentley Yes Representative Peyton Representative Peyton Yes
Representative Miller Representative Miller Representative Dotson Representative McGee Representative Eubanks Representative Eubanks Representative Wardlow That would be a yes
Unknown speaker
56:29
Is that a yes? Yes, Chair Leitemann. Yes. Congratulations, your bill is passed.
Representative Bryant, did you want to present SB 259? Okay, you're
Speaker 10
57:11
recognized. It's okay with the chair. I'd like to bring up Secretary Bassett. Yes. Please introduce yourself and who you
Representative Justin Gonzales
Unverified
57:27
represent. Darrell Bassett, Department of Labor and Licensing. You're
Speaker 157
57:32
recognized. Thank you, Mr. Chair. Committee, this bill has been presented here before.
To start off what this bill is, is nothing new. This is something that Department of Health, before transformation in the Department of Labor Licensing, has charged and issued. A Class T license is for city or municipal or county personnel that need to hire staff to be able to inspect by code air conditioners that get installed into our homes to help facilitate the training and the tools needed for the department to issue those licensing and inspect the licensees, they need to charge
a fee, which they have been doing with the license for the last 14 to 17 years. So this is definitely new. With that, I'd like to pass it over to the secretary. Maybe he can add some history to where
Speaker 161
58:25
the funds go and what the funds are used for. Not much other
Speaker 162
58:29
than that. It's a simple bill. I do appreciate it, Mr. Chairman and members of the committee with the opportunity to come and just kind of share a little light on how this bill came about. When we inherited the 21 different agencies in the Department of
Labor and Licensing, one of the things that we did was go through all of them to look at their legislative authority. Upon a review of this particular, the HVAC section, we discovered that there was no specific legislative authority to be charging these entities $25 a head. And so then we were faced with two options. We could either just ignore it and assume that the legislature intended 16 years ago
to be that vague and ambiguous, or we could do the right thing, which is call it to your attention so that we could get specific legislative authority and continue the training. And so that's how this thing came about. It's not a new fee. We're not asking for any additional money. We're just asking for the legislative authority to do what we've been doing for 16 years. Representative Allen, you're recognized for a question.
Representative Fred Allen
Unverified
59:47
Thank you, Mr. Chairman, and thank you, Mr. Secretary, and thank you, my fellow colleague, for bringing this bill. So I think what you all are trying to do is move it in the right direction, and I would like to make a motion
at the appropriate time. Thank you. Questions from committee?
Chair
Unverified
1:00:11
Representative Gonzalez, you're recognized. Thank you, Mr. Chair. Mr. Bissett, what's cash on hand in this license entity?
Representative Justin Gonzales
Unverified
1:00:18
You mean the fund balance? Yeah. Approximately
Speaker 165
1:00:21
$600,000. And you carry that over? how much over year to year? Well, it depends. As you know, it's special
Speaker 162
1:00:29
revenue, so it depends upon the needs. Right now, roughly half of that is allocated because we have a fleet of, I guess, six vehicles that have in excess of 150,000 miles. So at some point, we're going to need to start phasing them out. And so the money, of course, it's not static. It'll fluctuate by year, year by
Speaker 166
1:00:51
a year. Yeah, so it's my understanding from, continue, it's my understanding from the previous testimony that the money collected from these fees raises about $7,000
Speaker 169
1:01:03
a year. Is that $7,500 a year? Total cost of the training, yes, sir. Total cost of the training
Speaker 162
1:01:09
is roughly $14,000. The HVAC board absorbs 50% of that so that it can help the cities out. So we absorb roughly 7,000 of the 14,000. That's the total cost of the training. Okay. I'm just trying to figure out,
Speaker 170
1:01:23
you got $300,000 unallocated every year. Why do we need to continue this
Speaker 162
1:01:30
fee? Well, the option is to, well, that would be an option that we would, in other words, eat the entire amount. At some point, then we would deplete the fund balance, and then we would have to come back to you for either some state general revenue or find
Speaker 165
1:01:50
some other cash inflow. But there's other funds going into this. This isn't
Speaker 170
1:01:55
the only fund going into this account, right?
Speaker 169
1:01:59
Well, it's fees for service. Yeah, this is the fees for service. So that's what creates the fund balance. Okay. Thank you. Thank you, sir. Representative Payton, you're
Speaker 47
1:02:13
recognized. Thank you, Mr. Chair. So So what type of vehicles do
Speaker 161
1:02:18
you drive? Because you mentioned $50,000 a head there. I was just curious. No, no, no. No, I didn't say. I said we
Speaker 162
1:02:25
had six vehicles, and their mileage is $150,000 in excess of $150,000.
Speaker 47
1:02:30
Right, but you said $300,000 for six vehicles. That would be
Speaker 161
1:02:33
$50,000 a piece. We're going to do roughly $25,000 a vehicle. So that's what we're doing. Well, that's $150,000, not $300,000. Well, those are the ones that we're looking at turning over right now. Okay. So
Representative John Payton
Unverified
1:02:47
if I could have a follow-up, Mr. Chair? Yes. So I'm noticing in the legislation that we're not changing. You have a Class L license at no charge. So it's not unprecedented to have a license at no charge.
Speaker 162
1:03:02
Can you explain why this one is different? No, it's not. Well, it's just all we're asking to do is to continue to do what the health department has been doing for 16 years. That was the legislative intent, I assume, 16 years ago, was for us to charge $25 a head, and so that's what we're asking to be able to continue to do. I think we understand that. Thank you. Any other questions?
Seeing none, anyone here to speak against the bill? For
Speaker 177
1:03:38
the bill, seeing none, you ready to close for
Speaker 157
1:03:43
your bill? I can't close. And, colleagues, I understand that the hesitation for something in that we have done that isn't by law. But there's two scenarios here. There is the existence of a Class T license, which a Class T license means whenever you call the governing authority where you live and you ask that city or that county to come inspect your property during the construction phase,
you're asking for somebody to show up that is knowledgeable in subject matter. Now, most cities can't go hire an HVAC. They'll make a whole lot more working in industry than they will be working for the city. So they hire somebody that's in a trade, electrician, plumber. Maybe they get off by chance hiring a gentleman or a lady that's certified in HVAC. Regardless, that city needs to send them off to training to learn how the basics of HVAC work, that the flow is right for your evaporator in your house so it doesn't flood your attic and cause more damage.
There's several things within that license that cities need to make sure that their employees are aware of. And part of this statute adds that license into that code. Is that accurate? Of course, with that training comes cost. And so the cities will absorb this cost. If you give the no fee, the cities are still going to charge you for your permit for your house. They're still going to charge the HVAC guy or gal or company the fees to pull a permit.
And the cities, they will figure out how to train them or they may not because there's no requirement by the state to do that. So it's a hard bill to look at in the sense of we don't want to raise fees. We don't want to create something that maybe we didn't want to have eventually. But we've had it for 14 years. It's been very successful and it's very useful. And I think as our citizens look at
Speaker 160
1:05:42
that, they want somebody to show up that's knowledgeable in that field that they can count on. So with that, I'm closed.
What's the will of the committee? I made a motion. Yes, Representative Allen, you're recognized. Oh, I thought I made a motion. Not yet. Do pass. I made a motion, do pass. I have a motion, do pass. Any discussion on the motion? Seeing none, all in favor signify by saying aye. Aye. Those opposed, nay. No. I'm going to say the no's haven't. Sorry, your bill has failed. I only see one hand.
I'll move on to SB 625, Representative Gray. You're recognized to present the bill. Thank you, Mr.
Representative Michelle Gray
Unverified
1:06:45
Chair. If I could have Jamie Barker come sit up at the table with me. Yes,
Speaker 136
1:06:50
if you would introduce yourself and who you represent.
Representative Mary Bentley
Unverified
1:06:54
Thank you, Mr. Chair. Jamie Barker representing the Permanent Cosmetics Institute. You're recognized
Speaker 185
1:07:02
to present. Thank you. Go ahead. So the bill, while it's very lengthy, is relatively simple. We are moving the permanent cosmetics and body art industry from underneath the Department of Health to underneath the Board of Cosmetology. We're creating a board seat on that board to give some input from that industry onto the board from an industry expert, and that's really what we're doing.
The intent and the reason this bill was brought is that people in the industry felt like, as permanent cosmetics have come to be extremely, much more prevalent over the last couple years, the way they're educated, the schools that have popped up, the people out there doing them, there have been some evidence of bad actors and people that aren't really qualified to do this well. While they may be licensed, not operating the way they're supposed to, And so there were some issues of how it's enforced, and they just felt that moving themselves under the Cosmetology Board,
giving themselves a seat at the table, and ability to help weed out bad actors in their own industry would be a better way to go about that. We worked with the Department of Health and got their thoughts on how best to go about that, and this is kind of where we landed. They're neutral on the bill. And so if you don't know what permanent cosmetics are, this is, there's basically two types. There are the purely cosmetic type, which is essentially similar to tattooing, some sort of ink going into the skin for eyebrows, eyeliner, lip liner, et cetera. And then there's what's called paramedical ones. So a woman who
has had a double mastectomy wants to regain the appearance and some normalcy again. And so a permanent cosmetic would be able to allow her to have an appearance of nipples again. And so with that obviously comes some very sensitive cases and there i did not distribute pictures on purpose because some of them are extremely graphic but you can simply google botched permanent cosmetics if you'd like and you'll see evidence of what can happen if someone is able to practice and do this without being held to the standard that we'd like them to be held and this is not creating a new
license the license already exists now we're simply moving them under the board
of cosmetology any questions from committee representative bentley you recognize just one quick
Representative Mary Bentley
Unverified
1:09:16
question is the cosmetology board on base with this move i have not heard any opposition to this
okay thank you any other questions from committee
seeing none thank you for your comments anyone here speak against the bill
for the bill seeing none ready to close for
Speaker 191
1:09:43
your bill i'm closed mr chair and i make a
motion do pass i have a motion do pass any discussion on the motion seeing none all in favor signify by saying aye all opposed nay motion passes congratulations your bill is passed i don't see one hand uh dr cloud oh i'm sorry representative cloud did you have a motion
Representative Joe Cloud
Unverified
1:10:08
Yes, sir. I would like to move that we suspend the rules so that I can
Speaker 65
1:10:14
run SB 388 that was inadvertently misplaced over on the
House. That's a valid motion, not debatable. All in favor, signify by saying aye. Aye. All opposed, nay. Motion carries. Just for the record, it takes two-thirds vote, and I think we got that. Representative Cloud, you're recognized to present SB 388.
Representative Joe Cloud
Unverified
1:10:38
Thank you, Mr. Chairman. Thank you for that leeway committee. SB 388 is a licensure bill. Currently, the Arkansas Department of Health license abortion clinics, and you have to have or you have to perform 10 abortions in one month in a calendar year in order to qualify to being licensed. And so what this has created, it's created an inequity. So if a facility performs one to nine abortions in a month, they do not have to be licensed, and this bill will correct
that. So if a facility performs a abortion, they will have to obtain a license and then be under the rules and regulations of the Department of Health. The other thing this does is there's... Representative Cloud. Yes, sir. Just a second. If
you want to look at that bill, it is on the referred list. Sorry. So you can look at the bill. I'm
Representative Joe Cloud
Unverified
1:11:37
sorry, go ahead. Okay. The other thing this bill does currently, there are not any hospitals in the state that perform abortions, and this bill just puts that in code so that if there are abortions performed,
they will be in outpatient clinics, and that's it. I'll be glad to take questions. Any questions from committee?
Seeing none Anyone here to speak against the bill For the bill Seeing none You ready to close for your bill I'm close for my bill And make a motion due pass Have a
motion due pass Any discussion on the motion Seeing none All in favor signify by saying aye
Aye Those opposed nay Motion carries Congratulations your bill is passed Thank you chairman Thank you committee Committee we are adjourned Roll call.
Agenda
CONCUR IN SENATE AMENDMENT
Number Sponsor Subtitle
HB1063 Dotson TO AMEND THE TELEMEDICINE ACT; TO AUTHORIZE ADDITIONAL REIMBURSEMENT FOR TELEMEDICINE VIA TELEPHONE; AND TO DECLARE AN EMERGENCY.
HB1177 L. Johnson TO AUTHORIZE EMERGENCY MEDICAL SERVICES PERSONNEL TO ADMINISTER CERTAIN EMERGENCY PRESCRIPTION MEDICATIONS TO A PATIENT WHO HAS A SPECIFIC HEALTH CONDITION.
HB1836 Vaught TO AMEND THE LAW REGARDING THE DIVISION OF ENVIRONMENTAL QUALITY; AND TO AMEND THE PENALTY FOR THE KNOWING REFUSAL OF RIGHT OF ENTRY AND INSPECTION TO DIVISION OF ENVIRONMENTAL QUALITY PERSONNEL.
CONSENT AGENDA *Bills in Red added 04-15-2021
Number Sponsor Subtitle
HB1871 Scott TO ESTABLISH THE CREATING A RESPECTFUL AND OPEN WORLD FOR NATURAL HAIR (CROWN) ACT.
REGULAR AGENDA
Number Sponsor Subtitle
HB1428 Miller TO CREATE THE MEDICAID EXPANSION EFFICIENCY ACT OF 2021; AND TO DECLARE AN EMERGENCY.
HB1890 Ladyman TO CREATE A STUDY ON THE COMMERCIAL APPLICATION OF EXISTING TECHNOLOGY TO RECLAIM AND REPURPOSE SPENT NUCLEAR FUEL RODS.
HB1910 Christiansen TO AMEND THE LAW CONCERNING THE AUTHORITY OF THE ARKANSAS FIRE PROTECTION SERVICES BOARD.
HB1911 Bryant TO AMEND THE LAW REGARDING PUBLIC ASSISTANCE; AND TO AUTHORIZE A
PILOT PROGRAM RELATED TO REAL-TIME EMPLOYMENT AND INCOME DATA FOR CERTAIN PUBLIC ASSISTANCE.
HB1923 S. Meeks TO MODERNIZE OUTDOOR LIGHTING; TO CREATE THE OUTDOOR LIGHTING ACT; AND TO REPEAL THE SHIELDED OUTDOOR LIGHTING ACT.
HB1935 Wing TO AMEND THE WORKERS' COMPENSATION LAW; AND TO PROVIDE FOR THE COMPENSABILITY OF MENTAL INJURY OR ILLNESS FOR EMERGENCY RESPONDERS.
SB514 B. Davis TO CREATE A LICENSE TO AUTHORIZE A COMPANY TO PROVIDE SKILLED NURSING TASKS.
SB547 T. Garner TO AMEND CERTAIN PROVISIONS OF INITIATED ACT 4 OF 1948; AND TO REGULATE A DIRECT SELLER AS AN INDEPENDENT CONTRACTOR.
SB590 T. Garner TO END MANDATORY FACE COVERING REQUIREMENTS IN THE STATE OF ARKANSAS; AND TO DECLARE AN EMERGENCY.
SB395 Irvin TO MODIFY THE ANNUAL CAP ON DIAGNOSTIC LABORATORY SERVICES IN THE ARKANSAS MEDICAID PROGRAM.
SB259 Bledsoe TO AUTHORIZE THE LICENSURE OF STATE AND LOCAL GOVERNMENT HEATING, VENTILATION, AIR CONDITIONING, AND REFRIGERATION INSPECTORS; AND TO CORRECT REFERENCES TO THE APPROPRIATE CABINET-LEVEL DEPARTMENT.
SB332 Irvin TO ESTABLISH THE PUBLIC HEALTH READINESS ACT.
SB621 Hester TO REQUIRE THE ARKANSAS MEDICAID PROGRAM AND THE DEPARTMENT OF HUMAN SERVICES TO HAVE ALL CONSENT DECREES RECONSIDERED.
SB625 K. Hammer TO AMEND THE COSMETOLOGY TECHNICAL ADVISORY COMMITTEE; AND TO ESTABLISH PROCEDURES FOR LICENSURE AND REGULATIONS OF PERMANENT COSMETICS AND SEMIPERMANENT COSMETICS PROCEDURES.
SCR7 Irvin TO ENCOURAGE THE PURSUIT OF NATIONAL CANCER INSTITUTE DESIGNATION BY THE WINTHROP P. ROCKEFELLER CANCER INSTITUTE AT THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES.
SB595 D. Wallace TO CLARIFY THAT THE DEPARTMENT OF HUMAN SERVICES IS THE AGENCY THAT REGULATES LONG-TERM CARE FACILITIES; AND TO REMOVE REFERENCES TO THE OFFICE OF LONG-TERM CARE.
SB388
DEFERRED BILLS
Number Sponsor Subtitle
HB1857 Gonzales TO MODIFY THE DUTIES OF THE ARKANSAS STATE MEDICAL BOARD AND THE ARKANSAS STATE OCCUPATIONAL THERAPY EXAMINING COMMITTEE.
HB1247 Gonzales TO MODIFY PHYSICIAN DISPENSING; AND TO ALLOW DELEGATION OF PHYSICIAN DISPENSING.
HB1644 Bentley TO AMEND THE LAW CONCERNING EDUCATIONAL REQUIREMENTS UNDER THE CHILDCARE FACILITY LICENSING ACT; AND TO AMEND THE DEFINITION OF "CHILDCARE FACILITY" AS IT RELATES TO THE CHILDCARE FACILITY LICENSING ACT.
HB1266 M. Gray TO CLARIFY THE PROFESSIONAL RELATIONSHIP REGARDING COSMETIC AESTHETIC SERVICES.
HB1233 Penzo TO CREATE THE ARKANSAS NATUROPATHIC PHYSICIAN LICENSURE ACT.
HB1378 Penzo TO AUTHORIZE OCCUPATIONAL OR PROFESSIONAL LICENSURE FOR
INDIVIDUALS WHO ARE MIGRANTS FROM THE COMPACT OF FREE ASSOCIATION ISLANDS.
HB1564 Hawks TO AMEND THE TEACHER MANAGER INSTRUCTOR CERTIFICATION RELATING TO BARBERS.
HB1016 Rye ALEX'S LAW: TO IMPROVE RESIDENTIAL SWIMMING POOL SAFETY TO PREVENT CHILD DROWNINGS.
HB1324 Gazaway TO GIVE PREGNANT WOMEN PRIORITY ACCESS TO SUBSTANCE ABUSE TREATMENT AND RECOVERY SERVICES; AND TO DECLARE AN EMERGENCY.
HB1498 Gazaway CONCERNING THE CIVIL ENFORCEMENT OF CERTAIN CAUSES OF ACTION AGAINST A LONG-TERM CARE FACILITY BY A RESIDENT OF THAT FACILITY.
HB1667 Furman TO CREATE THE UNIVERSAL LICENSING RECOGNITION ACT.
HB1708 Eaves CONCERNING REACTIVE ATTACHMENT DISORDER TRAINING.
HB1764 F. Allen TO EXEMPT BARBERS FROM LICENSING RESTRICTIONS BASED ON CRIMINAL RECORDS.
HB1681 Payton TO CREATE THE FOOD FREEDOM ACT; AND TO EXEMPT CERTAIN PRODUCERS OF HOMEMADE FOOD OR DRINK PRODUCTS FROM LICENSURE, CERTIFICATION, AND INSPECTION.
HB1580 Scott TO CREATE THE COMMISSION ON RACIAL INEQUITIES IN MATERNAL MORTALITY.
HB1762 K. Ferguson TO CREATE THE CANCER PREVENTION AND CANCER PATIENT NAVIGATION ACT; AND TO IMPROVE THE CARE OF CANCER PATIENTS IN THIS STATE.
HB1799 M. Gray TO ALLOW AUTOMATIC CLAIM CROSSOVER IN THE ARKANSAS MEDICAID PROGRAM FOR ALL THIRD PARTIES WHO ARE PRIMARY PAYERS.
HB1757 Penzo TO REQUIRE CERTAIN INFORMED CONSENT WHEN PRESCRIBING OR ADMINISTERING ORAL CONTRACEPTIVES.
HB1759 L. Johnson TO PROVIDE ADDITIONAL MEDICAID COVERAGE FOR CHILDREN, PREGNANT WOMEN, AND POSTPARTUM MOTHERS AND BABIES.
HB1263 Pilkington TO ESTABLISH THE ARKANSAS ANESTHESIOLOGIST ASSISTANT ACT; AND TO PROVIDE FOR LICENSURE OF ANESTHESIOLOGIST ASSISTANTS.
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH, WELFARE AND LABOR COMMITTEE- HOUSE, Apr 15, 2021 | Agenda | 3 | Official source ↗ |
Speakers
Representative Jack Ladyman Chair
Unverified
Speaker 5
Representative Josh Miller
Unverified
Speaker 4
Speaker 10
Representative Justin Boyd
Unverified
Speaker 17
Representative Jim Dotson
Unverified
Representative Mary Bentley
Unverified
Representative John Payton
Unverified
Speaker 56
Speaker 57
Speaker 58
Speaker 60
Speaker 47
Speaker 65
Representative Joe Cloud
Unverified
Speaker 38
Speaker 78
Speaker 83
Speaker 90
Representative Jeff Wardlaw
Unverified
Speaker 115
Chair
Unverified
Speaker 117
Speaker 122
Speaker 124
Speaker 126
Speaker 18
Speaker 135
Speaker 55
Representative Justin Gonzales
Unverified
Speaker 157
Speaker 161
Speaker 162
Representative Fred Allen
Unverified
Speaker 165
Speaker 166
Speaker 169
Speaker 170
Speaker 177
Speaker 160
Representative Michelle Gray
Unverified
Speaker 136
Speaker 185
Speaker 191